Bivalirudin vs. Heparin in Acute Coronary Syndromes: The MATRIX Findings

Uncertainty remains about the optimal antithrombotic regimen for people with an acute coronary syndrome who undergo coronary angiography and anticipated percutaneous coronary intervention (PCI). To address this issue, investigators made use of additional randomizations nested within a previously published open-label trial of transradial versus transfemoral access in 8404 people. In this partially manufacturer-funded substudy, 7123 people were randomized to bivalirudin or unfractionated heparin. In addition, of the 3610 patients randomized to bivalirudin, the authors compared people with and without infusion prolonged to the post-PCI period. The average age was about 65 years; 56% had an ST-segment myocardial infarction (STEMI). Randomizatio…